The Invisible Dead

The grisly truth about the Super Bowl abortion ad.

Tim Tebow, the college football hero and Heisman Trophy winner, won't be in next Sunday's Super Bowl. But he's already one of its stars. Focus on the Family, an interest group opposed to abortion, will air a 30-second commercial featuring Tebow and his mother, Pam. According to the group's press release, the Tebows "will share a personal story centered on the theme of 'Celebrate Family, Celebrate Life.' "

Will Saletan writes about politics, science, technology, and other stuff for Slate. He’s the author of Bearing Right.

The story, apparently, is about Tim's birth in 1987, when his parents were missionaries in the Philippines. According to Pam's account in the Gainesville Sun, she contracted amoebic dysentery and went in a coma shortly before the pregnancy. To facilitate her recovery, she was given heavy-duty drugs. Afterward, doctors told her the fetus was damaged. They diagnosed her with placental abruption, a premature separation of the placenta from the uterine wall. They predicted a stillbirth and recommended abortion.

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But Pam was against abortion, and she had faith in God. She refused. Today, her reward is a healthy, athletic, stellar son. "I've always been very [pro-life] because that's the reason I'm here, because my mom was a very courageous woman," Tim told reporters last week. That's the prescribed moral of the story: Choose life. Dave Andrusko, the editor of National Right to Life News, puts it eloquently: "This amazing young man is able to share his many gifts because, and only because, Pam Tebow said no to abortion and yes to life."

Pam's story certainly is moving. But as a guide to making abortion decisions, it's misleading. Doctors are right to worry about continuing pregnancies like hers. Placental abruption has killed thousands of women and fetuses. No doubt some of these women trusted in God and said no to abortion, as she did. But they didn't end up with Heisman-winning sons. They ended up dead.

Being dead is just the first problem with dying in pregnancy. Another problem is that the fetus you were trying to save dies with you. A third problem is that your existing kids lose their mother. A fourth problem is that if you had aborted the pregnancy, you might have gotten pregnant again and brought a new baby into the world, but now you can't. And now the Tebows have exposed a fifth problem: You can't make a TV ad.

On Sunday, we won't see all the women who chose life and found death. We'll just see the Tebows, because they're alive and happy to talk about it. In the business world, this is known as survivor bias: Failed mutual funds disappear, leaving behind the successful ones, which creates the illusion that mutual funds tend to beat market averages. In the Tebows' case, the survivor bias is literal. If you're diagnosed with placental abruption, you have the right to choose life. But don't be so sure that life is what you'll get.

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Placental abruption is rare. The detachment from the uterine wall can range from partial to total. By most accounts, it occurs in fewer than 1 percent of pregnancies. The more broadly it's diagnosed, the less fatal it is on average, since the subtlest cases are also the least dangerous.

In 2001, the American Journal of Epidemiology published an analysis of 7.5 million births that took place in the United States in 1995 and 1996. Abruption was documented in 46,731 of these pregnancies. Six percent of normal pregnancies produced babies with birth weights low enough to risk long-term health damage. Nearly half the abrupted pregnancies produced such babies. Ten percent of normal pregnancies ended in premature births; most abrupted pregnancies ended that way. In normal pregnancies, the perinatal mortality rate—death of the fetus after 20 weeks gestation, or death of the baby in its four weeks after birth—was less than 1 percent. In abrupted pregnancies, the rate was roughly 12 percent. If the total number of abrupted pregnancies in the United States in those two years was 46,731, then the number of fetuses and babies killed by placental abruption was 5,570.

And that's just the U.S. number. In less developed countries, studies have found higher rates of perinatal death. In Thailand, a 2006 review of 103 abrupted pregnancies showed a rate of 16 percent. In Sudan, an analysis of more than 1,000 cases from 1997-2003 yielded a rate of 20 percent. In Tunisia, a 2005 review of 45 cases indicated a rate of 38 percent.

If you see no moral difference between an early fetus and a late fetus or baby, you can argue that any perinatal death rate short of 100 percent is better than preemptive abortion. But what about the women who carry abrupted pregnancies? For them, the potential complications include internal bleeding, hemorrhagic shock, kidney damage, embolisms, and heart failure. The Thai study reported hemorrhagic shock in 19 percent of women with abrupted pregnancies. In Burkina Faso, a 2003 review of 177 abrupted pregnancies reported a maternal death rate of 4 percent. In Pakistan, a 2009 review of 106 cases found a maternal death rate of 5 percent. By some estimates, placental abruption causes 6 percent of all maternal deaths.

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I can't tell you what drugs Pam Tebow was given or how severe her abruption was. I sent her a query through Focus on the Family three days ago and haven't heard back. But remember, she was doing missionary work in the Philippines. The perinatal and maternal death rates from abruption in her area were probably closer to the rates in Pakistan or Burkina Faso than to the U.S. rate. She and her son are with us today not just because of courage but because of luck.

And don't forget her age. Pam entered the University of Florida at 17 and graduated in 1971. That would make her about 37 years old in 1987, when she developed her abruption. She and her husband were literally praying for another baby. In that situation, at that age, carrying a compromised pregnancy to term carries an additional risk: that you'll lose not just this baby but the ability to conceive another. That's a further reason why a doctor might recommend abortion—or why a woman might choose it.

Pro-lifers have always struggled with the invisibility of unborn life: millions of babies aborted every year, concealed in wombs behind closed doors. How do you open the world's eyes to what it can't see? In Tim Tebow, they see the invisible made visible: a child who has lived to tell his story because an abortion didn't happen. "If his mother had followed her doctor's advice," notes LifeSiteNews, "he would be just another abortion statistic."

But what's true of abortion is also true of pregnancy complications. If Pam Tebow's abruption had taken a different turn, her son would be just another perinatal mortality statistic, and she might be just another maternal mortality statistic. And you would know nothing of her story, just as you know nothing of the women who have died carrying pregnancies like hers.

And what do you know of the women who chose to abort in similar circumstances? You never saw their tears for the life lost. You never heard their prayers for another chance. Maybe you've seen them rocking their babies or laughing with their toddlers. But did you make the connection? Do you know their stories? Is Pam Tebow's choice the only way to celebrate life and family?

Pam made a brave choice, and she has raised a fine son. Celebrate his life. But celebrate her luck, too—and say a prayer for all the women and babies who didn't make the cut. Human Nature's latest short takes on the news, via Twitter: